Provider Demographics
NPI:1740510577
Name:LOWE, AZIZA L (MSSA)
Entity type:Individual
Prefix:MS
First Name:AZIZA
Middle Name:L
Last Name:LOWE
Suffix:
Gender:F
Credentials:MSSA
Other - Prefix:MS
Other - First Name:LYNDA
Other - Middle Name:G
Other - Last Name:LOWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:2600 NW GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-2420
Mailing Address - Country:US
Mailing Address - Phone:541-752-5170
Mailing Address - Fax:
Practice Address - Street 1:2600 NW GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-2420
Practice Address - Country:US
Practice Address - Phone:541-752-5170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-29
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORLCSW 12781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical